Use of multiparametric magnetic resonance and transrectal ultrasound software fusion – guided prostate biopsy not only for significant prostate cancer

Česká verzia

Authors: Tomáš Vavřík ¹; Olga Dolejšová ¹; Hana Sedláčková ¹; Dušan Mrkos ¹; Jiří Ferda ²; Jan Kastner ²; Radka Fuchsová ³; Ondřej Topolčan ³; Ondřej Hes ⁴; Milan Hora ¹
Authors place of work: Urologická klinika LF UK a FN Plzeň ¹; Klinika zobrazovacích metod LF UK a FN Plzeň ²; Laboratoř imunochemické diagnostiky LF UK a FN Plzeň ³; Šiklův ústav patologie LF UK a FN Plzeň ⁴
Published in the journal: Ces Urol 2018; 22(4): 257-265
Category: Original Articles

Summary

The aim:

Evaluation of the first results of software fusion – guided prostate biopsies in our workplace using multiparametric magnetic resonance and transrectal ultrasonography.

Methods:

Overall, 128 patients underwent 3 T mpMRI/TRUS fusion software‑based targeted biopsy of prostate from 1/2017 to 3/2018. 22 of them, were biopsy‑naive men with suspicion of prostate cancer. Re‑biopsy were performed in 106 men with persistent suspicion of prostate cancer after previously negative standard biopsy. The average age of patients was 66.5 years (49–84). Median PSA was 8.49 ng/ml (3.87–60.16 ng/ml) and median PHI was 55.84 (18–266). Results: In total, prostate cancer was bioptically verified in 77 patients (60.2%). In 50 cases (65%) Gleason score (GS) 6 (3+3), in 19 cases (24.7%) GS 7 (3+4), by five patients (6.5%) GS 7 (4+3), two patients (2.5%) GS 8 (4+4), one patient (1.3%) GS 9 (4+5). PI‑RADS v2 SCORE was evaluated in 128 patients. 33 patients had a PI‑RADS score 3, of whom 14 were positive (42%), score 4 was present in 54 patients – 33 of whom were positive (61.1%) and score 5 was in 41 patients – 29 of whom were positive (70.7 %).

Conclusion:

In our sample of patients we observed a high percentage of GS 6 (3+3). Our results are different compared to world literature, which shows large identification of significant prostate cancer detected by mpMRI. This finding may be due to several reasons, poor selection of patients, inaccurate radiological description, or a patologist’s histological specimen. Detection of biopsy‑verified prostate cancer using 3 T mpMRI/TRUS fusion software‑based targeted biopsy increases proportionally compared to the increasing PI‑RADS score version 2. To confirm these results, an extended patient population study is required.

KEY WORDS

Magnetic resonance imaging, prostate cancer, software fusion guided prostate biopsy.

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